Somewhere around 30 percent of runners will experience a side ache at some point while running.[1] Runners usually experience this side cramping as a sharp pain just under the ribcage. Also known as “side stitches” amongst runners, the pain can be caused by diaphragm muscles spasming, ingesting sugary fluids before running, or nerve irritation.[2] While it may not always be possible to prevent side aches, there are some strategies you can try. If you get a side ache while running, then there are also some things you can do to get rid of it.

Steps

Method1

Taking Precautions to Prevent Cramping

1

Do not run right after eating. The up-and-down jolting impact associated with running stretches certain ligaments around the diaphragm (also referred to as gut tugs). This stretching is one possible cause of side stitches.[3] Eating shortly before a run adds more weight and matter to tug at and stretch those ligaments, which can cause cramping.[4]

Avoid full meals at least two hours (and up to four hours depending on your experience with the cramping) before a run.[5] Also, avoid even small food items starting one hour before you run.[6]

2

Do not drink too much liquid directly before a run. Though staying hydrated is essential to avoiding muscle cramping while running, drinking too much can have the opposite effect. Fluids sloshing around can lead to tugging on ligaments the same way that food can. Studies have shown that drinking large amounts of any drink—from water to sports drinks to soda—before a run can lead to side cramping.[7]

However, the intensity of the cramping increases with heavier, sugary drinks, including soda and fruit juices.[8][9]

3

Strengthen your core muscles. This is a long-term step toward alleviating side stitches, but strengthening your abdominal and lower back muscles will tighten up your core in a way that may decrease the ligament stretching responsible for the cramping.[10]

Planks and pushups are great exercises for tightening core muscles.[11] For information on strengthening your core muscles, visit How to Strengthen Your Core.

4

Warm up before you run. The way you breathe during a run has an effect on your diaphragm and the ligaments that can lead to cramping. A warmup that allows you to increase your running speed gradually helps you control your breathing in a way that may minimize the risk of cramping.[12]

Start with a brisk walk before your run and then work up to a jog, and then begin running. For more info on proper warm-up exercises before running, take a look at How to Warm up for Running.

Unless you’ve done a warmup before running in cold conditions, you’re more likely to breathe erratically during the initial portion of your run.[13]

5

Take full, deep breaths as you run. Short, shallow breathing keeps the diaphragm in a higher position and that puts more stress on the connective ligaments.[14] By taking deeper breaths, you lower your diaphragm in a way that can decrease the risk of cramping.[15] Try to remain mindful of your breathing during your run.

6

Take it easier down steep hills. As your momentum increases down a steep hill, you make harder impacts with each step, which increases the gut tugging responsible for diaphragm spasms. Try jogging down especially steep hills rather than going full force.[16]

Method2

Taking Steps to Alleviate Cramping

1

Slow down your pace. You probably won’t want to keep going at full speed with a cramp regardless, but slow down your pace when a cramp comes on.[17] The lower impact of the slower pace will immediately reduce the up-and-down tugging and ligament stretching behind the cramp.

2

Take several rapid deep breaths. For the same reason that deep breathing can help prevent cramping, it can also help alleviate cramps once they start. Quickly take in a deep breath, which will force down your diaphragm and relieve the stress on the surrounding ligaments.[18] Hold the breath for several seconds, then exhale with force through pursed lips.[19]

Repeat several times until the cramp goes away.

3

Tighten your abdominal muscles. If deep breathing alone doesn’t help alleviate the pain after several seconds, try bending over—which can help you expel each breath more fully—and tightening your abdominal muscles as you do.[20] These combined actions can help reduce the stress on your diaphragm even further to stop the cramping.

4

Tighten a belt around your waist. While not particularly helpful during a run away from home, tightening a belt around your waist has also proven helpful in stopping pain related to side stitches.[21] Try this if you have a home treadmill or remember to bring a belt to the gym with you.

5

Hold the area beneath the pain firmly. If you don’t have a belt handy, simply try using your hand to firmly grasp the area on your waist below the pain.[22] Side stitches are almost always on one side of the body (typically right) with the pain centered just below the ribcage. As you exhale, pinch this area between your thumb and fingers, and then relax your grip as you inhale.[23]

This may not work as effectively as a belt, but combined with deep breathing, it should alleviate the cramp in five or six breaths.[24]

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Tips

Some physicians also believe that a spinal dysfunction can increase stress on the diaphragm and surrounding ligaments. If nothing seems to help and you suffer from chronic cramping during runs, consider seeing a physical therapist or a chiropractor to check the alignment of your spine.[25]